Kids finally have an appointment with a counselor...

[doc2b]

What is the name of your state (only U.S. law)? MI

Just to recap (instead of having to reread old posts...), my stepdaugther had a doc's appointment a couple of weeks ago about headaches, stomach problems, etc. and was recommended counseling because the doc believed it was all stress related.

My husband made an appointment for the kiddos to see counselors and told mom about it last week (they're tomorrow). She's now saying that she won't let them go because medicaid won't cover the 50% that the private insurance that dad is providing doesn't cover. (She's responsible for medical bills up to a certain dollar amount because she is paid a medical supplement each month by dad, but refuses to spend it. She has the option to obtain private insurance through her company for the kids at about $25 a month, but won't do it because their medicaid plan has no copay for covered services since they also have primary insurance through dad, but there are many services that they don't cover, including child/adolescent therapy).

Can dad take the kids to the appointment and just pay for the copay himself?(we can afford a at least a couple of months at this point, beyond that I'm not sure). Mom's only objection to the counseling this time around is that she won't pay anything out of pocket for it...
Dad doesn't want another debaucle like last doctors appointment (and he got this one scheduled on his time , but has been waiting for almost two years to get the kids into therapy so they have an outlet and can get some help.

Also, when dad contacted Medicaid to find out what services were covered so that he could coordinate benefits, they informed him that he had no access to their kids medical info/benefits because he was not listed as their father nor as an authorized representative for the children. He contacted them by fax with his info/ss/drivers license and court order to try and fix this, but isn't he supposed to have equal access to their medical info? Their mom has access to their primary insurance info and benefits coordination...seems weird to me.

Thanks for any input!

 

[wileybunch]

Can dad take the kids to the appointment and just pay for the copay himself?(

Sure! Until last year, I never sent any co-pays for OOP expense reimbursements to my ex. It's not that he wouldn't pay, it's just not a big deal to me.

 

[doc2b]

Sure! Until last year, I never sent any co-pays for OOP expense reimbursements to my ex. It's not that he wouldn't pay, it's just not a big deal to me.

I will let him know-thanks, Wiley!

Dad just got off the phone with the Michigan Department of Community Health (who handles adding on authorized reps for Medicaid cases)...they told him that mom has to be the one to add him on to gain any access to the kids medical info, and they couldn't discuss anything else with him. He said the woman he was speaking with was very apologetic, but told him there was nothing she or anyone there could do to get him access to the benefits or medical info without mom's direct consent (which she won't give). He said from the way the woman sounded, there was something "weird" about the case. Is access to a copy of the provider list and covered benefits through their medicaid something that he can get court ordered at their hearing next month? I thought parents with joint legal and physical custody were legally allowed access to all medical, school, etc records?

And on the topic of medical insurance...since mom and dad are both co'd to provide medical insurance through their employer if it's at a reasonable cost to them(what defines reasonable?), and mom is choosing not to, can he/should he bring that up while he's there too? The kids being on straight medicaid is causing a lot of problems as to where he can/can't make their appointments because a lot of places don't take the health plan that they're on.

 

[TinkerBelleLuvr]

reasonable is 5% of income.

 

[xxnatalixx]

I will let him know-thanks, Wiley!

Dad just got off the phone with the Michigan Department of Community Health (who handles adding on authorized reps for Medicaid cases)...they told him that mom has to be the one to add him on to gain any access to the kids medical info, and they couldn't discuss anything else with him. He said the woman he was speaking with was very apologetic, but told him there was nothing she or anyone there could do to get him access to the benefits or medical info without mom's direct consent (which she won't give). He said from the way the woman sounded, there was something "weird" about the case. Is access to a copy of the provider list and covered benefits through their medicaid something that he can get court ordered at their hearing next month? I thought parents with joint legal and physical custody were legally allowed access to all medical, school, etc records?

And on the topic of medical insurance...since mom and dad are both co'd to provide medical insurance through their employer if it's at a reasonable cost to them(what defines reasonable?), and mom is choosing not to, can he/should he bring that up while he's there too? The kids being on straight medicaid is causing a lot of problems as to where he can/can't make their appointments because a lot of places don't take the health plan that they're on.

Wish my insurance company was as careful...they gave step mom access to my account and even let her change the address to hers. I couldn't even access my account online because she set it up with her email address!

 

[TinkerBelleLuvr]

I will let him know-thanks, Wiley!

Dad just got off the phone with the Michigan Department of Community Health (who handles adding on authorized reps for Medicaid cases)...they told him that mom has to be the one to add him on to gain any access to the kids medical info, and they couldn't discuss anything else with him. He said the woman he was speaking with was very apologetic, but told him there was nothing she or anyone there could do to get him access to the benefits or medical info without mom's direct consent (which she won't give). He said from the way the woman sounded, there was something "weird" about the case. Is access to a copy of the provider list and covered benefits through their medicaid something that he can get court ordered at their hearing next month? I thought parents with joint legal and physical custody were legally allowed access to all medical, school, etc records?

And on the topic of medical insurance...since mom and dad are both co'd to provide medical insurance through their employer if it's at a reasonable cost to them(what defines reasonable?), and mom is choosing not to, can he/should he bring that up while he's there too? The kids being on straight medicaid is causing a lot of problems as to where he can/can't make their appointments because a lot of places don't take the health plan that they're on.

Dad may have to do a "show cause" if mom won't cooperate.

 

[doc2b]

reasonable is 5% of income.

Thanks-I thought I read it somewhere, but I'm too absent minded to remember details like that right now

So, if they're imputing her min. wage at full time (unless she actually submits her income info), the $300 or so per year it would cost her would not be unreasonable?

Also, Tink (if you're still on here)...Dad called the FOC to see how to get a copy of the worksheet they used to calculate CS and they told him that they don't have anything like that How the heck do they have a CS recommendation without any worksheet showing incomes used, overnights, etc? Are they bs'ing him?

 

[doc2b]

Wish my insurance company was as careful...they gave step mom access to my account and even let her change the address to hers. I couldn't even access my account online because she set it up with her email address!

Whoa, nelly...I can't believe they let her do that! But, a lot of stuff has been happening lately that I can't believe, so I guess I need to get over my disappointment in people's stupidity

 

[doc2b]

Dad may have to do a "show cause" if mom won't cooperate.

Ugh...why is everything like pulling teeth?

Anybody have an opinion on whether the counseling for the kids should be private sessions or if they should have mom and dad in the room? The kids are kind of uncomfortable with mom and dad together in the same room, but not with either individually (not to mention mom and dad don't usually have a good outcome when they're in the same room together for more than 5 minutes).

In my opinion (which doesn't count ) the kids would benefit more from some personal time to discuss how things are going with their counselors without the pressure of mom or dad in the room, but I don't know anyone that's gone through this to ask...dad wants to know before they go to the appointment if he should ask that the parents stay out of the room after the initial consultation so the kids can have some privacy. Anyone have any experience to share?

 

[TinkerBelleLuvr]

The counseling appointments are for the children. In the sessions, I have either gone in for a few minute in the very beginning, or at the end to give a "progress" report. Now, if the counseling appointment is for the parent and child to communicate better, then both parties need to be in there.

And I do understand the bit about medicaid. I found out after the fact that I had to give explicit information to "authorize" dad on the account. I ASSumed that dad had access. On regular insurance, I've called about the children on both insurances so I didn't know different. I didn't do it to be difficult - I just didn't know.

 

[doc2b]

The counseling appointments are for the children. In the sessions, I have either gone in for a few minute in the very beginning, or at the end to give a "progress" report. Now, if the counseling appointment is for the parent and child to communicate better, then both parties need to be in there.

And I do understand the bit about medicaid. I found out after the fact that I had to give explicit information to "authorize" dad on the account. I ASSumed that dad had access. On regular insurance, I've called about the children on both insurances so I didn't know different. I didn't do it to be difficult - I just didn't know.

Thank you, and thank you!
The appointment is strictly for the kiddos (for now, anyway).
The medicaid info is great to have...I'll let dad know to ask mom again to add him on to have access, but there are no guarantees. From what it sounded like, she doesn't feel he "needs" to have access to provider info, etc because she can call and find it out and relay it to him (unfortunately, it just never works that way). Hopefully, she'll get them on her insurance through work and all of these problems will be done with. (She and dad have the same ins. through work, so between the two, there will be virtually no copay or deducible to pay at all...and the premium to add the kiddos on will cost her about the same as the medical supplement he pays her, so she won't be out any out of pocket money).

 

[MichaCA]

My experience is when I have done an initial consultation with daughters' therapist (she has had two), the therapist meets with the parents first, then sets an appt with the child. I'm sure they are all different, however once the initial consultation is done, a good therapist will get a hit on what the issues are, and meet with the child accordingly, meaning she will determine when or if to ask a parent to be in the room with the child. The therapy is for the child, so certain confidences do apply...so I would leave all that stuff up to the counselor.

I firmly believe dad can go ahead and just take the child, pay for it. The only downside I see, not legally, is that it is good when both parents take the child (take turns in some fashion) so the therapist gets a realistic picture of the child with both parents...even just at transitions. I do know my ex got it COURT ORDERED (as if I were denying him access) that we take turns taking daughter. While I think that was off the top, I do see the importance of both parents being involved, if they can/want to be.

I just went through a similar thing with medi-cal (my insurance, dad provides zero insurance) with dad, also regarding therapy. I thought he had full access...I AM IN CA so this is medical but I would think they are pretty similar benefits....to her records as I have provided him with all numbers, etc. I finally got that straightened out...he should be able to call. I do know there is a number to call, and I think medicaid may well indeed have a list of therapists. Its more cumbersome than private...you have to really convince the worker that the child needs therapy. In our case it was in a court order so much easier.

Bottom line, mom SHOULD absolutely be providing dad with every bit of pertinent medical access information, and if she doesn't, I would make that a request in court.

But the private should be good. I did not understand...regarding TinkerBellLuvr's post about the 5%...does that mean mom can only be ordered to pay 5%? I have always paid half of daughters therapy and for two years it was $90 a session. Before that I was going to suggest, not knowing how much it costs dad for medical insurance, that both parents pay half of the copay bringing the price down a bit.

Sorry so long winded, no coffee yet. good luck, Micha

 

[doc2b]

Good grief...

This just came through by email (just read it to dad at work)...

Dad,

You do not have my consent for taking the kids there. In fact, I want to wait to see if Daughter has a medical issue for her stomach. I do not believe the kids need counseling yet. I think this would create undue anxiety for them. Daughter has an appointment at doctor's on xx/xx/09 at xx:xxam.

Mom

After stating she had an objection to paying the copay by email, she sent another one asking if he was still taking the kiddos. He replied yes, and this was the response she just sent. WTH is he supposed to do? This is getting ridiculous...the counseling was "prescribed" by the kids' pcp. How does counseling cause undue anxiety to kids that are having a hard time coping with the crap-pile that was formed after their parents divorce?

 

[wileybunch]

Ugh...why is everything like pulling teeth?

Some people apparently enjoy high drama. Maybe it's like a cheap drug for them.

Assuming Dad has been clear that he needs this access and Mom has surely told him "no" already, Dad should send Mom a no nonsense letter explaining that she is obligated to provide him access, cite any relevant language from the CO, and let her know she has until xx/xx/xxxx to provide the access or he will need to seek a resolution elsewhere, but that if he bears time and expense in doing so, he will be seeking relief from that as she is obligated to provide this to him.

 

[TinkerBelleLuvr]

doc2b asked what percentage of income is "reasonable" for insurance

The answer is:
5%

So, if you make make $600/week, they consider it "reasonable" if the parent pays no more than $30/week for that child's insurance.

I know that I pay WAYYYYY more than that percentage, but I also cover other children because I am supposed to cover my child.